Research On CT And MRI Diagnosis Of Neck Non-parenchyma Organ-derived Primary Tumor

ObjectiveTo improve CT and MRI diagnosis corresponding to pathology by analyze CT and MRI features of neck non-parenchyma organ-derived primary tumor.Materials and MethodsA retrospective analysis of CT and MRI data in 51 cases of neck non-parenchyma organs-derived primary tumor whom confirmed by pathology in our hospital.The situation of tumor and shape,diameter,relations with adjacent tissue or organs,density or signal intensity in plain scan and enhancement,movenment of adjacent vessel in CT and MRI imaging.Histology types of neck non-parenchyma organs-derived primary tumor on CT and MR imaging appearances were compared to the corresponding pathologic fundaments in order to provide reliable evidences for proper accurate diagnosis.ResultsFifty-one neck non-parenchyma organs-derived primary tumor cases were enrolled in our study,including 19 cases of neurilemmoma,8 cases of carotid body tumor,5 cases of neurofibroma,6 cases of lymphangioma,4 cases of rhabdomyosarcoma,2 cases of angiosarcoma,2 cases of primitive neuroectodermal tumor,1 case of myxoinflammatory fibroblastic sarcoma,1 case of myofibroblastic tumor,1 case of leiomyosarcoma,and 1 case of malignant peripheral nerve sheath tumor,1 case of teratoma.The tumor is located in the cervical area of 2 cases,lateral cervical region of 48 cases,posterior neck in 1case.The difference of age and gender was no significant in our study.Differences of the shape,the boarder,the density/signal intensity and enhancement ways among neurogenic tumors,lymphangiomaa and sarcomas were statistic significant.Neurogenic tumors in CT and MRI were round(26/32),clear boarder(27/32)and homogeneity density/signal intensity(23/32).Lymphangiomas in CT and MRI were lobulated cystic masses(6/6),clear boarder(5/6)and inhomogeneity density/signal intensity(6/6).Sarcomas in CT and MRI were lobulated solid masses(8/11),unclear boarder(10/11)and inhomogeneity density/signal intensity(6/11).Differences of the shape,the density and enhancement ways among neurilemmomas,carotid body tumors and neurofibromas were statistic significant.Neurilemmomas in CT and MRI were rounded masses(18/19),low density in CT plain scan(6/11),medium enhancement(10/11).Carotid body tumors in CT and MRI were rounded masses(5/8),medium density in CT plain scan(6/6),high enhancement(6/6).Neurofibromas in CT and MRI were rounded masses(3/5),low density in CT plain scan(5/5),including 4 enhancement cases of low enhancement(1/4),medium enhancement(2/4)and high enhancement(1/4).Twenty-seven of 51 cases(27/51,52.9%)diagnostic imaging of CT/MRI corresponding to pathology.The corresponding rate was high with lymphangiomas(6/6)and carotid body tumors(7/8).Neurofibromas misdiagnosis rate was high(5/5)as lymphangiomas/cyst of 3,parotid gland cystadenoma of 1 and cellulitis of 1.Neurilemmomas were misdiagnosis(7/19)as lymph nodes of 3,lymphangiomas of 2,arotid body tumor of 1 and angioneoplasm of 1.ConclusionNeck non-parenchymal organ-derived primary tumor occurs mainly in the lateral neck area,the most common is neurogenic tumors,followed by sarcoma,neurogenic tumors were benign neurilemmoma.CT plain scan of neurilemmomas were low density,the density of carotid body tumors were medium density.The former was mild to moderate enhancement in enhanced scan,the later severe reinforcement and carotid artery bifurcation shows cup-shaped expansion.Lymphangioma occurs in children,the body of tumor is huge,boundary is clear,has multiple intervals,cystic part the tumor is moderate density and mostly located in lateral cervical region,very few pushing to the oropharynx.The corresponding rate was high with lymphangiomas and carotid body tumors.Neurofibromas misdiagnosis rate was high as lymphangiomas/cyst,parotid gland cystadenoma and cellulitis.Neurilemmomas were misdiagnosis as lymph nodes,lymphangiomas,arotid body tumor and angioneoplasm.